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India: health innovator's paradise
  1. Prashant Jha
  1. Biodesign, AIIMS, New Delhi, India
  1. Correspondence to Dr Prashant Jha, Biodesign, AIIMS, 108, Old OT Block, First Floor, AIIMS, New Delhi 110029, India; post{at}drpjha.com

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Let me start by acknowledging my bias: I am bullish on India! Let us start with the most fundamental premise of an innovator's mindset—every problem is an opportunity!1

While health is a very complex field to innovate—with many variables—there are at least six interconnected domains that determine the variables an innovator must consider while solving a problem:

  1. Reimbursement constraints.

  2. Disease complexity and variability.

  3. Skill sets of healthcare providers.

  4. Manufacturing and distribution networks.

  5. Talent availability.

  6. Health infrastructure.

An innovator in North America, Western Europe, Japan or a developed economy in APAC has a couple of them sorted out: a rather straightforward reimbursement pathway, powered by insurance; a very rigid medical education and licensing guidelines for a single discipline of medical care. This is an advantage—and a threat. An innovation that would work seamlessly in such a market would not work in the rest of world. With saturating markets in the developed economies, the med-tech giants and the next wave of innovators and entrepreneurs from across the globe look forward to emerging economies and markets as the next gold mine.

But the home advantage of a structured system becomes a curse. How has innovator training in leading universities responded? By sending a wave of backpacker innovators to go to ground zero and understand constraints and context of emerging economies.

Entrepreneurs, innovators, business leaders, marketing gurus all have frenzied itineraries, from Ghana to Mozambique, Dhaka to Malawi, Peru to Estonia. They come in search of insights on diseases, business dynamics, health infrastructure and other constraints.

India has a unique advantage for the next wave innovators. Let me walk you through them.

  1. Reimbursement constraints. All kinds of business models coexist rather peacefully here. Out-of-pocket: yes; insurance: yes; government funded: yes. That makes India a wonderful place to test a business model hypothesis.

  2. Disease complexity and variability. Name a country that has the highest disease burden of infectious diseases, the scourge from the previous century and the killer lifestyle diseases of present and future? India.

  3. Skillsets of healthcare providers. India has a wide range of practitioners, from general practitioners to specialists and super-specialists; barefoot doctors to faith-healers. All at times within a walking distance.

  4. Manufacturing and distribution networks. A resurgent economy and an ambitious make-in-India programme. While the make-in-India programme augments capacity, the manufacturing hubs of the world China, Vietnam and South Korea are in its neighbourhood.

  5. Talent availability. India remains one of the largest trainers of engineers and doctors. Among the global youth, the desire to train as an engineer remains the highest in India (http://qeprize.org/wp-content/uploads/2015/11/QEPrize-Create-the-Future-Report.pdf). The skewed doctor–patient ratio in India ensures that an Indian doctor cares for one of the highest number of patients per doctor (http://data.worldbank.org/indicator/SH.MED.PHYS.ZS?locations=IN). While there is much to be improved, the bright side is the need for technologies to be efficient to fit in the Indian doctor's busy practice.

  6. Health infrastructure. From a barefoot doctor in a village to the world-class cardiologist in the most advanced operating rooms. From the bone-healer on a pavement in the metropolis to the very benevolent primary health centres with a network of ASHA workers championing public-funded maternity services in rural India. India has it all (http://nrhm.gov.in/nrhm-components/rmnch-a/maternal-health/background.html; http://www.omicsonline.org/open-access/role-of-accredited-social-health-activists-ashas-in-the-improvement-ofhealth-status-of-villagers-under-nrhm-in-kolhapur-district-m-2161-0711-1000416.php?aid=72569).

When one looks from these lenses, India can be the healthcare innovation laboratory of the planet. The developed, developing and underdeveloped healthcare systems all coexist within a few kilometres of each other in India. Consider any city—Delhi, Bengaluru, Chennai, Patna, Kolkata or Hyderabad—there is a Malawi, there is a Boston and there is a Ghana. You just need to choose a healthcare facility to walk into. This diversity and the peacefully coexisting chaos is the perfect crucible for the ideas to mutate and innovations to be born.

Want to innovate for the healthcare of humanity? Welcome to the innovator's playground and paradise. Welcome to India!

Reference

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Footnotes

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

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